Cancer Patients With Major Depressive Disorder: Testing a Biobehavioral/Cognitive Behavior Intervention
Cancer Patients With Major Depressive Disorder: Testing a Biobehavioral/Cognitive Behavior Intervention
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DOI：
10.1037/a0022566
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发表时间：
2011-04-01
影响因子：
5.9
通讯作者：
Andersen, Barbara L.
中科院分区：
文献类型：
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作者：
Brothers, Brittany M.;Yang, Hae-Chung;Andersen, Barbara L.
目的：在这项二期试验中，我们评估了一种针对抑郁症患者应对癌症压力的新型心理治疗方法。研究了生物行为干预（BBI）和认知行为疗法（CBT）相结合的有效性。方法：参与者是 36 名被诊断患有重度抑郁症的癌症幸存者（平均年龄 = 49 岁；88% 白人：92% 女性）。 A、采用单组前后期设计。治疗包括最多 20 次 75 分钟的 BBI/CBT 联合治疗。结果是访谈者的变化（汉密尔顿抑郁量表；Williams. 1988）和自评抑郁症状（贝克抑郁量表第二版；Beck, Steer, & Brown, 1996）以及癌症相关症状的变化（疲劳症状量表 [Hann et al., 1998] 和简短疼痛问卷 Maul, Cleeland, & Flanery, 19831) 和生活质量（医疗结果研究短片 36 号表格； Ware 等人，1995）。使用了混合效应建模、可靠性变化指数和广义线性模型。所有分析都是意向性治疗。结果：抑郁症状明显改善。此外，21 名研究完成者中有 19 名达到缓解标准。疲劳和心理健康生活质量也显着改善。并发的焦虑症和高水平的癌症应激（事件影响量表：Horowitz、Wilner 和 Alvarez，1979）均与开始和结束治疗时出现更严重的抑郁症状相关。结论：CBT 成分已成功纳入先前有效的减轻癌症应激的干预措施中。 BBI/CBT 干预值得进一步研究，以评估其与成熟的抑郁症治疗方法相比的疗效。
Objective: In this Phase II trial, we evaluated a novel psychological treatment for depressed patients coping with the stresses of cancer. Effectiveness of a combined biobehavioral intervention (BBI) and cognitive behavior therapy (CBT) was studied. Method: Participants were 36 cancer survivors (mean age = 49 years; 88% Caucasian: 92% female) diagnosed with major depressive disorder. A,single group pre-post design was,used. Treatment consisted of up to 20 individual 75-min combined BBI/CBT sessions. Outcomes were change in interviewer (Hamilton Rating Scale for Depression; Williams. 1988) and self-rated depressive symptoms (Beck Depression Inventory-Second Edition; Beck, Steer, & Brown, 1996) as well as change in cancer relevant symptoms (Fatigue Symptom Inventory [Hann et al., 1998] and Brief Pain Questionnaire Maul, Cleeland, & Flanery, 19831) and quality of life (Medical Outcomes Study Short Form-36; Ware et al.. 1995). Mixed-effects modeling, a reliability change index, and generalized linear models were used. All analyses were intent-to-treat. Results: Depressive symptoms significantly improved. In addition, 19 of 21 study.completers met criteria for remission. Significant improvements were also noted in fatigue and mental health quality of life. Both concurrent anxiety disorders and high levers of cancer stress (Impact of Events Scale: Horowitz, Wilner, & Alvarez, 1979) were each associated with beginning and concluding treatment with greater depressive symptoms. Conclusions: CBT components were successfully incorporated into a previously efficacious intervention for reducing cancer stress. The BBI/CBT intervention warrants further research in evaluating its efficacy compared with well-established treatments for depression.